This collaborative proposal will create new outpatient drug treatment capability; evaluate the efficacy of carbamezapine, trazodone, and desipramine in reducing cocaine craving and abuse in a double-blind, placebo-controlled design; and attempt to elucidate prognostic characteristics of substance abusers in outpatient treatment. Outpatient treatment will be offered at Samuel U. Rodgers Community Health Center and will include individual, family and group therapies, relapse prevention training, training in skills needed to maintain abstinence, and involvement in community support groups. Descriptive psychological and psychiatric testing, and information about drug use and sociodemographic data, will be obtained at admission and followup. The experimental pharmacotherapy trial will be offered to cocaine-abusing patients. Those wh wish to participate will be randomly assigned to active medication or placebo for an eight-week trial, following which, patients remaining in treatment and receiving active medication will be randomized to either the same active medication or its placebo to determine whether pharmacotherapy is helpful beyond eight weeks of treatment. This portion of the trial will continue for 14 weeks, at which time participation in the trial will be terminated. Patients receiving pharmacotherapy may also participate in outpatient treatment. All patients will be followed through 18 months to determine response to treatment. Outcome measures include severity of drug and alcohol abuse, days, amount and pattern of use, social, personal, psychological and psychiatric problems related to use. Because the experimental protocol will be offered in an outpatient treatment program, some sense of the interactio of treatment and adjunct pharmacotherapy should be forthcoming. We anticipate that this design will allow evaluation of the efficacy of these medication and will permit application of multivariate analyses that can help discover clusters of patient characteristics which interact with pharmacologic and non-pharmacologic treatment to predict the most favorable outcomes.